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31.08.2018 | Original Article

Estimating glomerular filtration rate in children: evaluation of creatinine- and cystatin C-based equations

verfasst von: Cathrin L Salvador, Camilla Tøndel, Alexander D Rowe, Anna Bjerre, Atle Brun, Damien Brackman, Lars Mørkrid

Erschienen in: Pediatric Nephrology | Ausgabe 2/2019

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Abstract

Background

Glomerular filtration rate (GFR) estimated by creatinine- and/or cystatin C-based equations (eGFR) is widely used in daily practice. The purpose of our study was to compare new and old eGFR equations with measured GFR (mGFR) by iohexol clearance in a cohort of children with chronic kidney disease (CKD).

Methods

We examined 96 children (median age 9.2 years (range 0.25–17.5)) with CKD stages 1–5. A 7-point iohexol clearance (GFR7p) was defined as the reference method (median mGFR 66 mL/min/1.73 m², range 6–153). Ten different eGFR equations, with or without body height, were evaluated: Schwartz_bedside, Schwartz_CKiD, Schwartz_cysC, CAPA, LM_REV, (LM_REV + CAPA) / 2, FAS_crea, FAS_cysC, FAS_combi, FAS_height. The accuracy was evaluated with percentage within 10 and 30% of GFR7p (P10 and P30).

Results

In the group with mGFR below 60 mL/min/1.73 m², the Schwartz_cysC equation had the lowest median bias (interquartile range; IQR) 3.27 (4.80) mL/min/1.73 m² and the highest accuracy with P10 of 44% and P30 of 85%. In the group with mGFR above 60 mL/min/1.73 m², the Schwartz_CKiD presented with the lowest bias 3.41 (13.1) mL/min/1.73 m² and P10 of 62% and P30 of 98%. Overall, the Schwartz_cysC had the lowest bias − 1.49 (13.5) mL/min/1.73 m² and both Schwartz_cysC and Schwartz_CKiD showed P30 of 90%. P10 was 44 and 48%, respectively.

Conclusions

The Schwartz_cysC and the combined Schwartz_CKiD present with lower bias and higher accuracy as compared to the other equations. The Schwartz_cysC equation is a good height-independent alternative to the Schwartz_CKiD equation in children and can be reported directly by the laboratory information system.

Clinical Trial Registration

ClinicalTrials.gov, Identifier NCT01092260, https://clinicaltrials.gov/ct2/show/NCT01092260?term=tondel&rank=2

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Titel: Estimating glomerular filtration rate in children: evaluation of creatinine- and cystatin C-based equations
verfasst von: Cathrin L Salvador
Camilla Tøndel
Alexander D Rowe
Anna Bjerre
Atle Brun
Damien Brackman
Lars Mørkrid
Publikationsdatum: 31.08.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Nephrology / Ausgabe 2/2019
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-018-4067-3

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Estimating glomerular filtration rate in children: evaluation of creatinine- and cystatin C-based equations